Advances in the understanding of cellular and molecular basis of tumor progression have spurred interest in the development of new targeted agents that are changing the therapeutic management of patients with cancer. In parallel to progression in the therapeutic area, new PET radiopharmaceuticals are being developed to guide the use of such targeted therapies. This article aims to give an overview on the role of PET imaging in the individualized management of patients affected by urologic and gynecologic malignancies, focusing on the most promising targets for therapies and for molecular imaging using PET.